Surgeons from Stellenbosch University and Cape Town’s Tygerberg Hospital have performed the world’s first successful penis transplant.

The nine-hour operation was performed Dec. 11 on the 21- year-old recipient, who made a full recovery and regained all functions in the transplanted organ, the South African university said in a statement Friday.

The patient, whose identity wasn’t disclosed, had his penis amputated three years ago in order to save his life when he developed complications after a traditional circumcision. There are an estimated 250 penile amputations each year in South Africa stemming from circumcisions, the university said.

“Our goal was that he would be fully functional at two years and we are very surprised by his rapid recovery,” said Andre van der Merwe, head of the university’s Division of Urology, who led the team during the operation.

It is the second time this type of operation was attempted and the first time that a successful long-term result was achieved, the university said.

“There is a greater need in South Africa for this type of procedure than elsewhere in the world, as many young men lose their penises every year due to complications from traditional circumcision,” said Van der Merwe.

“It helps a community of men,” Van der Merwe said in a phone interview. “These men have lost their penises in traditional circumcision. Nobody talks about them, they’re ostracized, they’re stigmatized and this is good news for them.”

Clinical Trial

South Africa is also home to the first heart transplant, which took place in 1967 at the Groote Schuur Hospital in Cape Town.

The patient who received the penile transplant is sexually active and will be able to have children if he chooses, Van der Merwe said. Doctors will monitor him for another three months before they operate on any of nine other men awaiting a penile transplant as part of a clinical trial Van der Merwe and his team started in 2010.

The transplanted penis wasn’t circumcised and it will be at least several months before the patient can return for the medical procedure since he’s now taking immunosuppressant drugs necessary to prevent rejection of the new body part.

Traditional male circumcision is a cultural initiation rite practiced by certain ethnic groups in South Africa, including the Xhosa and Ndebele. They often aren’t done in sterile environments and complications can occur including infection, gangreneand genital mutilation.

In the Eastern Cape Province, where the practice is common, there were 9 amputations of the penis and 43 deaths in 2013, according to a provincial department of health report.

Circumcision at birth isn’t a normal practice in South Africa, said Beth Skorochod, deputy director of HIV/TB at PSI, a global health organization based in Washington.

The rite of passage involved in traditional circumcision is different from a push the last several years by groups like PSI to get men, typically those 25 and older, to undergo the surgery in a medical setting as an HIV prevention method.